Public Health Promotion of Physical Activity – Filling Critical Research Gaps Russell Pate, Ph.D., FACSM Department of Exercise Science Arnold School of Public Health University of South Carolina

Background Physical activity (PA) provides important health benefits Physical activity (PA) provides important health benefits PA Guidelines PA Guidelines Adults: 150 minutes of PA per weekAdults: 150 minutes of PA per week Youth: 60 minutes of PA per dayYouth: 60 minutes of PA per day Most Americans do not meet these guidelinesMost Americans do not meet these guidelines

Prevalence of Meeting Guidelines Adult Self-Report – BRFSS 2005 Kruger et al. MMWR 2007;56(46): Percent

Prevalence of Meeting Guidelines Adult Objective Data - NHANES Troiano et al. Med Sci Sports Exerc 2008;40(1): Percent

Prevalence of Meeting Guidelines Youth Self-Report – YRBS 2007 Percent Eaton et al. MMWR 2008;(S S04):1-131

Prevalence of Meeting Guidelines Youth Objective Data - NHANES Troiano et al. Med Sci Sports Exerc 2008;40(1): Percent

Organizational Partners American Academy of Pediatrics American Academy of Pediatrics American Alliance for Health, Physical Education, Recreation, and Dance American Alliance for Health, Physical Education, Recreation, and Dance American Association of Retired Persons American Association of Retired Persons American Cancer Society American Cancer Society American College of Sports Medicine American College of Sports Medicine American Heart Association American Heart Association Centers for Disease Control & Prevention Centers for Disease Control & Prevention

A comprehensive plan for promoting physical activity in the American population would provide the framework to support a broad and comprehensive national effort to increase physical activity throughout the population.

Vision Vision All Americans are physically active and live, work, and play in environments that facilitate regular physical activity.All Americans are physically active and live, work, and play in environments that facilitate regular physical activity. Mission Mission Develop a National Plan for Physical Activity that produces a marked and progressive increase in the percentage of Americans who meet physical activity guidelines throughout life.Develop a National Plan for Physical Activity that produces a marked and progressive increase in the percentage of Americans who meet physical activity guidelines throughout life.

Goals Goals Provide a clear roadmap for actions that support short and long term progressProvide a clear roadmap for actions that support short and long term progress Develop strategies for increasing physical activity in all population subgroupsDevelop strategies for increasing physical activity in all population subgroups Create a sustained and resourced social movementCreate a sustained and resourced social movement

Social Ecological Model Child or Adolescent

Sectors 1. Public Health 2. Education 3. Transportation, Urban Design, & Community Planning 4. Mass Media 5. Healthcare 6. Business & Industry 7. Parks, Recreation, Fitness, & Sports 8. Volunteer and Non-Profit Organizations

Guide to Community Preventive Services Task Force on Community Preventive Services Task Force on Community Preventive Services Support from the US Department of Health and Human Services in collaboration with public and private partners Support from the US Department of Health and Human Services in collaboration with public and private partners Reviewed literature for PA interventions: Reviewed literature for PA interventions: Informational approachesInformational approaches Behavioral and social approachesBehavioral and social approaches Environmental and policy approachesEnvironmental and policy approaches Kahn et al. Am J Prev Med 2002;22(4S):

Effective Physical Activity Interventions

Public Health Strong Evidence Strong Evidence “Point-of-decision” prompts to encourage stair use“Point-of-decision” prompts to encourage stair use Community-wide campaignsCommunity-wide campaigns Social support in community settingsSocial support in community settings Individually-adapted health behavior change (most implemented in community settings)Individually-adapted health behavior change (most implemented in community settings)

Education School-Based Physical Education School-Based Physical Education Strong evidence for effectiveness in increasing PA and improving physical fitnessStrong evidence for effectiveness in increasing PA and improving physical fitness

Education Insufficient evidence Insufficient evidence Classroom-based Health Education (focus on information provision)Classroom-based Health Education (focus on information provision) Classroom-based Health Education (focus on reducing TV viewing)Classroom-based Health Education (focus on reducing TV viewing) College-based Health Education and Physical EducationCollege-based Health Education and Physical Education

Transportation, Urban Design, & Community Planning Creation of or enhanced access to places for PA combined with informational outreach activities Creation of or enhanced access to places for PA combined with informational outreach activities Strong evidence for effectivenessStrong evidence for effectiveness

Mass Media Insufficient evidence Insufficient evidence Mass media campaignsMass media campaigns

Sectors 1. Public Health (4, 0) 2. Education (1, 3) 3. Transportation, Urban Design, & Community Planning (1, 0) 4. Mass Media (0, 1) 5. Healthcare (0, 0) 6. Business & Industry (0, 0) 7. Parks, Recreation, Fitness, & Sports (0, 0) 8. Volunteer and Non-Profit Organizations (0, 0)

Large Scale PA Intervention Studies Education Education Active by Choice TodayActive by Choice Today CATCHCATCH CHICCHIC FitKid ProjectFitKid Project Know Your BodyKnow Your Body LEAPLEAP PathwaysPathways Planet Health PLAY Project FAB Project GRAD SPARK TAAG

Large Scale PA Intervention Studies Public Health Public Health Bootheel Heart Health ProjectBootheel Heart Health Project Heart to Heart ProjectHeart to Heart Project Minnesota Heart Health ProjectMinnesota Heart Health Project Stanford Five-City ProjectStanford Five-City Project Transportation, Urban Design & Community Planning Transportation, Urban Design & Community Planning Active Community EnvironmentsActive Community Environments Healthcare Healthcare ACT PACE PACE+ Mass Media Mass Media VERB Business & Industry Business & Industry Blair et al Bowne et al King et al LIFECHECK